Individual provider Active NPI

Emily Jayne Durham Harris, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Concord, NC
National Provider Identifier
1235846346
Registry record updated May 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
DURH-NY3ZM Issued in NC
Practice address
2324 Concord Lake Rd
Concord, NC 28025-2814
Phone
(704) 918-1343
Fax
(704) 461-4334
NPI assigned
Oct 31, 2022
Last updated
May 2, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X DURH-NY3ZM NC Primary

Addresses

Primary practice location

2324 Concord Lake Rd
Concord, NC 28025-2814

Mailing address

2324 Concord Lake Rd
Concord, NC 28025-2814
Phone (704) 918-1343

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231030000643 NC Practitioner - Nurse Practitioner 3678929569 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DURH-NY3ZMNCMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Carolina Pediatric Eye Specialists, PLLC CurrentSince Jun 13, 2024 Accepting new patients

Locations

1025 Vinehaven Dr NE
Concord, NC 28025
Phone (704) 795-5588

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1667174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682985600000",
    "number": "1235846346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2324 CONCORD LAKE RD",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280252814",
            "telephone_number": "704-918-1343",
            "fax_number": "704-461-4334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2324 CONCORD LAKE RD",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280252814",
            "telephone_number": "704-918-1343",
            "fax_number": "704-461-4334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "EMILY",
        "middle_name": "JAYNE DURHAM",
        "name_prefix": "Mrs.",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-31",
        "last_updated": "2023-05-02",
        "certification_date": "2023-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NC",
            "license": "DURH-NY3ZM",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, NC

Sources for this page

Verify at the official NPI Registry.